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Mahotra N, Chaudhary S, Poudyal P. Pre-eclampsia among Pregnant Women Admitted to the Department of Obstetrics and Gynaecology of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:840-843. [PMID: 38289744 PMCID: PMC10725235 DOI: 10.31729/jnma.8265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Pre-eclampsia is a pregnancy-related hypertensive disorder with maternal and neonatal complications. Many studies are done regarding the prevalence of pre-eclampsia in Nepal but ascertaining the maternal risk factors and fetal outcomes are important. The aim of this study was to find out the prevalence of pre-eclampsia among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care hospital from 13 July 2023 to 29 September 2023 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. Point estimate was calculated at a 95% Confidence Interval. Results Among 5065 patient, pre-eclampsia was seen in 44 (0.87%) (0.61-1.13, 95% Confidence Interval). A total of 16 (36.36%) cases of pre-eclampsia were in the age group 25-29 years and 30 (68.18%) of them were nulliparous. A total of 38 (86.36%) of the newborns of the pre-eclamptic cases had low birth weight. The APGAR score of newborns at the 1 minute after birth was 26 (59.09%) followed by the newborns who needed re-evaluation 16 (36.36%). The APGAR score recorded at 5 minutes showed maximum newborns with normal APGAR score 40 (90.90%). Conclusions The prevalence of pre-eclampsia among pregnant women was found to be lower than other studies done in similar settings. Keywords maternity; Nepal; pre-eclampsia; prevalence.
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Affiliation(s)
- Narayan Mahotra
- Department of Clinical Physiology, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - Sonam Chaudhary
- Department of Clinical Physiology, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - Pooja Poudyal
- Department of Gynecology and Obstetrics, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
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Lin XS, Peng XY, Yang MM, Ning LL, Shao YW, Jiang Y, Feng SW, Luo Q. The single pregnancy predicting model of 1 minute Apgar score less than 7 after preterm birth: A retrospective study. PLoS One 2022; 17:e0279385. [PMID: 36548293 PMCID: PMC9778627 DOI: 10.1371/journal.pone.0279385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Preterm delivery is greatly associated with perinatal mortality and morbidity, while there is no objective way to identify high-risk newborns currently. This study aimed at discovering the risk factor for Apgar score less than 7 at 1 minute of preterm neonates born with vaginal delivery. A retrospective study was performed in single pregnancy women with a vaginal delivery before 37 weeks of gestation. All the preterm infants were categorized into three types: very preterm birth (28 to 32 weeks), moderate preterm birth (32 to 34 weeks) and late preterm birth (34 to 37 weeks). Risk factors were identified through logistic regression analysis in every category of newborns mentioned above. And the receiver operating characteristic analysis was used in continuous variables to determine the best threshold of the outcome. On the basis of the selected factors, the predicting models are created and its prognosticating ability is compared by the area under the curve. A nomogram was established for the proved best model. A total of 981 cases were investigated, of whom 55 were found with 1 min Apgar scores less than 7. The nomogram was set for the predicting model with larger area under the receiver operating characteristic curve, of which is 0.742(95% confidence interval = 0.670-0.805) in very preterm birth, with the variables of first and second labor stage(> = 1.6 hours), birthweight and MgSO4(magnesium sulfate), and is 0.807(95% confidence interval = 0.776-0.837) in late preterm birth, with the variables of second labor stage(> = 1.23 hours), birthweight, a history of previous cesarean delivery, fetal distress and placental abruption. The combination of first and second labor stage, newborn weight and MgSO4 use can predict 74.2% of 1 minute Apgar score < 7 in very preterm neonates. And 80.7% high-risk infants can be identified when second labor stage, newborn weight, VBAC (vaginal birth after cesarean) and the occur of placental abruption and fetal distress were combined in the predicting model for late preterm birth. These predicting models would bring out great assistance towards obstetricians and reduce unnecessary adverse fetal outcomes.
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Affiliation(s)
- Xi-Shi Lin
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
| | - Xin-Yun Peng
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
| | - Meng-Meng Yang
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
| | - Lin-li Ning
- Hangzhou Fuyang Women and Children Hospital, Hangzhou, China
| | - Yu-Wei Shao
- Changxing Women and Children’s Hospital, Huzhou, China
| | - Ying Jiang
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
| | - Su-Wen Feng
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
- * E-mail: (QL); (SWF)
| | - Qiong Luo
- Department of Obstetrics, Women’s Hospital, Zhejiang University, School of Medicine, Hangzhou, China
- * E-mail: (QL); (SWF)
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Moawad EMI, Tammam ASF, Mosaad MM, Sayed HME, Atef A. Evaluating the predictive value of fetal Doppler indices and neonatal outcome in late-onset preeclampsia with severe features: a cross-sectional study in a resource-limited setting. BMC Pregnancy Childbirth 2022; 22:377. [PMID: 35501758 PMCID: PMC9063060 DOI: 10.1186/s12884-022-04704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Preeclampsia constitutes a major health problem with substantial maternal and perinatal morbidity and mortality. The aim of this study was to detect the diagnostic efficacy of fetal Doppler in predicting adverse outcomes in severe late onset preeclampsia (LOP). Methods A prospective study was conducted among childbearing women who presented with severe LOP and matched controls. Umbilical artery (UA) and middle cerebral artery (MCA) Doppler indices including pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) and cerebroplacental ratio (CPR) were measured. Results All UA indices were significantly higher in the case group compared to the controls (p < 0.001). UA PI and RI were significantly correlated with all neonatal adverse outcomes except cord pH status (p < 0.05). Abnormal CPR was the most sensitive index that positively correlated with intrauterine growth retardation (IUGR), low 5- minute Apgar score and neonatal intensive care unit admission (79, 72.8 and 73.3%, respectively). In the same context, Abnormal UA PI and RI represented the most specific tool for predicting IUGR, low 1- and 5- minutes Apgar score with positive predictive values were 52, 87 and 57%, respectively. Conclusion In severe LOP, UA Doppler remains the preferential indicator for adverse birth outcomes with CPR is the best index that could be solely used for predicting such outcome.
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Affiliation(s)
| | - Amr Samir Fouad Tammam
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Maha Mohamed Mosaad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Adel Atef
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt
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Kırmızı DA, Baser E, Onat T, Caltekin MD, Kara M, Yalvac ES. Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction? Z Geburtshilfe Neonatol 2020; 224:262-268. [PMID: 32590874 DOI: 10.1055/a-1177-1516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the rates obtained from hematological parameters in cases of late-onset idiopathic fetal growth restriction (FGR) with healthy pregnancies and to evaluate the effect on neonatal outcomes. METHODS The study group consisted of 63 pregnant women with late-onset idiopathic FGR and the control group consisted of 91 healthy pregnant women. The determined rates were calculated from the control hemograms of patients at 28 weeks. Both groups were compared for neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other parameters. RESULTS NLR, leukocyte and neutrophil levels were significantly higher in the FGR group (p<0.05). There was no significant difference in PLR, platelet and lymphocyte levels between the groups (p>0.05). To predict FGR, the best cut-off value of NLR was determined to be 4.11 with 56% sensitivity and 88% specificity values. CONCLUSION Neutrophil, lymphocyte and platelet interactions have an important role in FGR development. Inflammation can be involved in the etiopathogenesis in late-onset FGR.
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Affiliation(s)
- Demet Aydogan Kırmızı
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
| | - Emre Baser
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
| | - Taylan Onat
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
| | - Melike Demir Caltekin
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
| | - Mustafa Kara
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
| | - Ethem Serdar Yalvac
- Department of Obstetrics and Gynecology, Yozgat Bozok Universty, Medicine of Faculty, Yozgat, Turkey
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Abdelazim IA, Bekmukhambetov Y, Aringazina R, Shikanova S, Amer OO, Zhurabekova G, Otessin MA, Astrakhanov AR. The outcome of hypertensive disorders with pregnancy. J Family Med Prim Care 2020; 9:1678-1683. [PMID: 32509671 PMCID: PMC7266187 DOI: 10.4103/jfmpc.jfmpc_1054_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hypertensive disorders (HTDs) with pregnancy remain a major health problem because of the associated adverse maternal and perinatal adverse outcomes. OBJECTIVES To evaluate the outcomes of HTDs with pregnancy. PATIENTS AND METHODS Four hundred and five (405) hypertensive women included in this retrospective multicenter study. Data of the studied women including maternal age, parity, gestational age at delivery, pregnancy outcome [preterm delivery (PTD), birth weight (LBW), Apgar scores, neonatal intensive care unit admission (NICU), intrauterine fetal death (IUFD), intrapartum and/or early neonatal deaths] were collected. Collected data analyzed statistically to evaluate the outcome of HTDs with pregnancy. RESULTS Preeclampsia (PE)/superimposed PE group had significantly high relative risk (RR) and Odds ratio (OR) for PTD (RR 2.1; OR; 3.3; P = 0.0001 and P = 0.0001, respectively), LBW (RR 2.01; OR; 3.17; P = 0.0001 and P = 0.0001, respectively), and low Apgar score at 1st min (RR 1.7; OR 1.9; P = 0.01 and 0.01, respectively) and at 5th min (RR 2.2; OR; 2.36; P = 0.2 and 0.2; respectively). In addition, PE/superimposed PE group had significantly high RR and OR for NICU admission (RR 1.6; OR 2.2; P < 0.0002 and P < 0.0001, respectively) and IUFD (RR 2.9; OR 3.1; P = 0.01 and 0.01, respectively). CONCLUSION women with PE/superimposed PE have high RR and OR for PTD, LBW, and low Apgar score at 1st and 5th min, NICU, and IUFD compared to the gestational and chronic hypertension with pregnancy.
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Affiliation(s)
- Ibrahim A. Abdelazim
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
- Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait
| | - Yerbol Bekmukhambetov
- Department of Oncology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Raisa Aringazina
- Department of Internal Diseases № 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Svetlana Shikanova
- Department of Obstetrics and Gynecology № 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Osama O. Amer
- Department of Obstetrics and Gynecology, Ghamra Military Hospital, Cairo, Egypt
| | - Gulmira Zhurabekova
- Department of Normal and Topographic Anatomy, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | | | - Akezhan R. Astrakhanov
- Department of Internal Diseases № 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Okoye HC, Madu AJ, Korubo K, Efobi C, Eze OE, Obodo O, Okereke K, Ilechukwu G. Correlates of neutrophil/lymphocyte, platelet/lymphocyte, and platelet/neutrophil ratios of neonates of women with hypertensive disease of pregnancy with neonatal birth outcomes. Hypertens Pregnancy 2019; 38:105-110. [DOI: 10.1080/10641955.2019.1584819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Helen Chioma Okoye
- Department of Haematology and Immunology, University of Nigeria Campus, Ituku-Ozalla, Enugu, Nigeria
| | - Anazoeze Jude Madu
- Department of Haematology and Immunology, University of Nigeria Campus, Ituku-Ozalla, Enugu, Nigeria
| | - Kaladada Korubo
- Department of Haematology, University of Port Harcourt, Port Harcourt Nigeria, Nigeria
| | - Chilota Efobi
- Department of Haematology and Immunology, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
| | - Onyinye Ezinne Eze
- Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Onochie Obodo
- Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Kelechi Okereke
- Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Gladys Ilechukwu
- Department of Haematology and Immunology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
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